Individual
DR. RUSTON MICHAEL KOONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3901 W MARKHAM ST, LITTLE ROCK, AR 72205-5527
(501) 664-6017
Mailing address
3901 W MARKHAM ST, LITTLE ROCK, AR 72205-5527
(501) 664-6017
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD15428
AR
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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